1. Field of the Invention
The present invention relates to a new and improved wedge for use with tubular casts commonly provided for the treatment of fractured limbs. More particularly, the cast wedge of the present invention is especially suited and adapted for use in connection with limb casts formed of wrapped cloth impregnated with Plaster of Paris.
2. Description of the Prior Art
In treating limb fractures, physicians often employ tubular casts for immobilizing the fracture and these casts are constructed around the broken bone by first wrapping the limb with cotton gauze or other suitable dressing material on both sides of the fracture area followed by the application of a cloth wrapping impregnated with wet Plaster of Paris which hardens in a short time after the wrapping has been completed.
The hardened Plaster of Paris provides a firm, rigid tubular cast which supports the broken limb on both sides of the fracture area and provides the desired immobilization of the fracture so that the bone may begin to heal and knit together. Often times as the healing process continues, it is desirable to adjust the longitudinal alignment of the bone portions on opposite sides of the fracture area and this is often done without removing the existing cast from the broken limb. An alternative procedure would entail completely removing the existing cast and then constructing a new cast on the limb with the desired shape to achieve the intended bone alignment.
The procedure which does not require removal of the existing cast is usually faster, cheaper and more accurate in producing the precise and necessary adjustments in bone alignment within the cast to promote the best knitting of the fractured bone.
In this process, a transverse cut is made in the wall of the cast about 2/3 to 3/4 of the way around the complete circumference, but leaving a small portion of the cast (the remaining 1/3 or 1/4) intact without cutting. This uncut portion serves as a hinge between the portions of the cast on opposite sides of the transverse cut.
In the prior art, various types of spacers or wedges were then inserted between the facing edges of the cut in the cast directly opposite the uncut hinge portion. These wedges provided the desired amount of spacing to form a precise degree of angular adjustment between the portions of the cast on opposite sides of the cut. These wedges are often made of wood, dowels, sheet padding, Plaster of Paris and anything handy in the cast room, usually on an ad hoc basis. After insertion of a wedge it is held in place only by additional wrapping of cloth impregnated by Plaster of Paris. Often times it is necessary to repeat the procedure and provide sucessive transverse cuts in the cast wall and different wedges to progressively change the angular adjustment of the cast portions as healing of the fracture proceeds.
One of the problems associated with this type of procedure is the lack of readily available, objects for use as wedges or spacers. Another problem is the tendency of some of the objects often used such as pieces of wood, splints or gauze padding to move relative to the cast or change shape after installation. In some cases, these objects change or permit change in the spacing interval between the opposite facing edges of the cut in the cast wall. Moreover, wedging objects of a particular size are not readily available and fabrication of wedges or spacers requires additional physician time.
U.S. Pat. No. 2,295,253 is directed to a fracture aligner in which windows are cut in the wall of a tubular cast so that selectively adjustable pressure pads can be applied to effect bone displacement. This type of cast may result in a relatively high concentration of pressure on a relatively small area on the surface of the limb adjacent the fracture.